Abstract:
In 1997 Lymphatic Filariasis was identified as one of the Neglected Tropical Diseases
that could be eliminated. The Global Program to Eliminate Lymphatic Filariasis, through
national programs, depends on mass drug administration (MDA) of antifilarial and
antihelminthic drugs to over 80% of the poputalion at-risk for a period of 4 – 6 years to
interrupt transmission of the disease and control morbidity caused by LF. National
programs are responsible for the distribution, control and evalatuion of MDAs. In
Kenya, MDA was initiated in 2002 and MDA administered in 2002, 2003, 2005 and
2008. Parasitologic surveys were conducted in eight sentinel communities in Malindi
sub-County after four annual MDAs with 6mg/kg of diethylcarbamazine in combination
with 400mg albendazole. MDA was not administered to the targeted at risk-population
in 2004, 2006 and 2007 due to insufficient funding. Analysis of Variance and KruskalWallis tests were employed to determine quantitative differences in the study
communities. The McNemars and Wilcoxon signed ranks test were used to test for the
change in microfilaremia and antigenemia among the participants using paired data
collection before and after the MDA at α=0.05. At baseline, 1447 participants were
tested using the Immunochromatographic card test and night blood specimens were
collected from all ICT positive participants. Prevalence rates were compared using a
Chi-square test. Antigen prevalence among the communities ranged from 34.4% in
2002, 26.2% in 2003, 18.7% in 2004, 14.0% in 2007 and 11.4% in 2009 respectively,
while the microfilaremia prevalence’s measured 20.9% in 2002, 10.5% in 2003, 7.1% in
2004, 1.9% in 2007 and 0.9% in 2009. By 2009, after four rounds of treatment, the
number of mf positive individuals were 10 compared to the 297 in 2002 was statistically
significant (p < 0.001). The mean value for the microfilaria count among the eight
communities was at a steady decrease from 43.6 in 2002 to a 0.1 in 2009. Despite the
missing of two rounds of treatment, there was a general decrease in the overall
microfilaremia and antigenemia over time but no interruption of transmission. There is
need for evaluation and further surveillance. There may also be need to extend the 4 – 6
year recommended period of mass treatment.
